But Susan Telford, who owns Telford’s Pipe and Cigar in unincorporated Mill Valley with her husband Brian, said, “This ordinance will probably put us out of business. We are the only full-service tobacconist in Marin.”

Preceding the vote, Marin County Public Health Officer Dr. Matt Willis laid out the rationale for the ban.

“Vaping products are more frequently consumed by young people than they are by adults,” Willis said. “The reality is young people are vaping at alarming rates.”

Vaping is the act of inhaling and exhaling the aerosol produced by a vaporizer or e-cigarette.The device creates the aerosol or vapor by heating a cartridge that typically contains flavored oils and nicotine.

Willis said he was spurred into action after getting the results of the most recent California Healthy Kids Survey in September. The survey, conducted by the state Department of Education, showed that from 2016 to 2018 frequent vaping increased among all Marin students from seventh through 11th grade.

The largest increase, from 11 percent to 28 percent, was among 11th-graders. Frequent vaping increased for Marin seventh-graders from 2 percent to 5 percent and for ninth-graders from 9 percent to 20 percent.

Willis said that four out of five adolescents who smoke tobacco start with a flavored product and teenagers who use electronic smoking devices are more likely to move on to smoking tobacco. Approximately 90 percent of adult smokers begin smoking before the age of 18.

Willis said a typical e-cigarette cartridge contains the same amount of nicotine as an entire pack of traditional cigarettes. That is significant for young smokers since nicotine affects brain development up to age 25.

Dr. Matt Willis, Marin County Public Health Officer, speaks to the county supervisors during a hearing to consider a ban on flavored tobacco Tuesday. (County of Marin photo)

Some people are attracted to vaping because they think it lacks the health risk of smoking tobacco. Willis, however, said that e-cigarettes are not safe; besides nicotine the vapor they produce contains cancer-causing chemicals, heavy metals, volatile organic compounds, and flavoring such as diacetyl, a chemical that has been linked to serious lung disease.

If adopted, the ban would also apply to traditional cigarettes containing menthol. The Family Smoking and Prevention Act, signed by President Barack Obama in 2009, prohibited the sale of flavored traditional cigarettes with the exception of menthol.

Willis said menthol cigarettes mask the harsh effect of smoke in the lungs and are a favorite among African-American and younger smokers.

During the public comment portion of the meeting that followed Willis’s presentation, Phillip Gardiner, co-chairman of the African-American Tobacco Control Leadership Council, said, “This at bottom is a social justice issue.

“Predatory marketing of flavored tobacco products has been aimed at the African-American community in particular for the last 50 years,” Gardiner said.

The Telfords, who said they don’t sell vaping products at their store, weren’t the only ones to criticize the proposed ordinance Tuesday. Marilyn Pepper asked about the effect on retailers.

“What happens to their business model? How are they compensated for lost sales?” Pepper asked. “All of their ancillary sales will also be affected. “

Jaime Rojas, a spokesman for the National Association of Tobacco Outlets, said, “Retailers are not the problem. Our members are law-abiding responsible business owners who do not to sell to youths. It is already illegal to sell and to market to youths.

“In the Amazon.com era you cannot simply ban a product and consider it the perfect solution,” Rojas said, “especially when a product is legal under federal and state laws.”

Both supervisors Kate Sears and Arnold asked Willis if he had considered exempting adults from the ban on flavored tobacco products.

Willis said that in order to keep the products from getting to kids a comprehensive ban is needed. He also noted e-cigarettes are not approved by the Federal Drug Administration as a means of quitting smoking, even though they are often touted as a safe smoking substitute.

Willis also reminded the board of the toll that smoking continues to take in lives and dollars. Tobacco is the leading cause of preventable death in the U.S. responsible for 480,000 deaths annually and $289 billion in annual costs.

In Marin alone, where 10 percent of the population continues to use tobacco, health care and lost productivity costs an estimated $138 million annually.

John Maa, president of San Francisco/Marin Medical Society, was among the many speakers who voiced their support for the ban Tuesday.

“As a surgeon over the decades, I’ve witnessed the hidden cost of smoking to society that we often don’t discuss ,” Maa said. “Wound infections, reoperations, readmission to the hospital. These are all significant and borne by the taxpayers.”

Lori Bremner, who works with the American Cancer Society’s Cancer Action Network, said there is a “multi-billion-dollar industry that continues to develop new products to attract new young smokers to replace the ones that they kill with their products.

Dr. Grant Colfax, director of the county Department of Health and Human Services, said, “This proposal will save lives. That is why we are supporting it.”

If approved, the ban would be phased in over a six-month period to give tobacco retailers time to sell existing inventory. Stores that sell only tobacco would be given a full year to prepare.

Fairfax, Sausalito and Novato have already passed some form of ban or restriction on flavored tobacco sales, and other Marin municipalities are expected to follow Marin County’s lead if the ban is adopted.